Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.16 / $241.58 / $403.26	Facility		$13.16	$241.58	$403.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.48 / $29.48 / $29.48	Facility	26	$29.48	$29.48	$29.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.16 / $84.81 / $124.52	Professional		$47.16	$84.81	$124.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $56.34 / $126.58	Professional	26	$28.33	$56.34	$126.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.58 / $29.82 / $48.65	Professional	52	$23.58	$29.82	$48.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.69 / $52.92 / $64.33	Professional	TC	$17.69	$52.92	$64.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.12 / $34.22 / $63.05	Facility		$16.12	$34.22	$63.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.57 / $41.64 / $97.46	Professional		$17.57	$41.64	$97.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $65.15 / $186.71	Professional		$42.58	$65.15	$186.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $37.02 / $76.78	Professional	26	$27.34	$37.02	$76.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $32.22 / $109.94	Professional	TC	$15.15	$32.22	$109.94
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.23 / $216.66 / $290.00	Facility		$170.23	$216.66	$290.00
United Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $79.40 / $133.15	Professional		$51.75	$79.40	$133.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $35.79 / $49.76	Professional	26	$23.38	$35.79	$49.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $41.63 / $84.86	Professional	TC	$23.26	$41.63	$84.86